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Objective: To provide a review of journal articles discussing clinical cases or vignettes of psychoanalysis or psychoanalytic psychotherapy of patients affected by bipolar disorder. Methods: A thorough search of journal articles was performed in five databases to identify studies published from 1990-2021. Results: Twenty-four articles were included in this review, comprising a total of 29 case reports. The most common theoretical approach adopted by the authors was “object relations.” Two main sets of clinical-theoretical considerations and recommendations emerge: the applicability of analytic treatment to patients with bipolar disorder – taking into account their analyzability and practical arrangements for conducting therapy – and theoretical speculations on the nature and development of the illness, as well as on the conceptualization of its different phases. Conclusion: Our findings reveal that there is some psychoanalytic literature providing insight into the psychological dynamics and treatment of patients with bipolar disorder. Elaboration of this literature may help improve our understanding and provide more accurate and comprehensive descriptions of the intrapsychic and interpersonal dynamics of these patients, yielding potentially valuable information for clinical and research purposes, particularly with regard to reducing interpersonal conflict, and increasing insight and engagement with lifestyle changes and other behaviors likely to promote health and stability.

Objective: To provide a review of journal articles discussing clinical cases or vignettes of psychoanalysis or psychoanalytic psychotherapy of patients affected by bipolar disorder. Methods: A thorough search of journal articles was performed in five databases to identify studies published from 1990-2021. Results: Twenty-four articles were included in this review, comprising a total of 29 case reports. The most common theoretical approach adopted by the authors was "object relations." Two main sets of clinical-theoretical considerations and recommendations emerge: the applicability of analytic treatment to patients with bipolar disorder - taking into account their analyzability and practical arrangements for conducting therapy - and theoretical speculations on the nature and development of the illness, as well as on the conceptualization of its different phases. Conclusion: Our findings reveal that there is some psychoanalytic literature providing insight into the psychological dynamics and treatment of patients with bipolar disorder. Elaboration of this literature may help improve our understanding and provide more accurate and comprehensive descriptions of the intrapsychic and interpersonal dynamics of these patients, yielding potentially valuable information for clinical and research purposes, particularly with regard to reducing interpersonal conflict, and increasing insight and engagement with lifestyle changes and other behaviors likely to promote health and stability. [ABSTRACT FROM AUTHOR]

Copyright of RumeliDE Journal of Language & Literature Research / RumeliDE Dil ve Edebiyat Araştırmaları Dergisi is the property of RumeliDE Uluslararasi Hakemli Dil & Edebiyat Arastirmalari Dergisi and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To study the application effect of mindfulness meditation training combined with group yoga intervention in patients with manic depression. Methods 56 patients with manic depression who were admitted to Department of Psychiatry of The Third People's Hospital of Xinhui District of Jiangmen from August 2017 to February 2019 were selected and divided into a control group (26 cases) and an observation group (30 cases) by sealed envelope randomization. Both groups were given routine nursing and medication. On this basis, the control group was given group yoga intervention, while the observation group was given mindfulnes meditation training and group yoga intervention. After 8 weeks of intervention, the scores of Hamilton Depression Rating Scale (HAMD), Bech-Rafaelsen Mania Rating Scale (BRMS), Metacognitions Questionnaire-330 (MCQ-30) and quality of life were compared between the two groups. Results Before the intervention, there were no significant differences in HAMD scores and BRMS scores between the two groups (both P > 0. 05). After the intervention, the above scores of the two groups were reduced, and the observation group had significantly lower scores than the control group (both P <0.05). Before the intervention, there were no significant differences in MCQ-30 scores between the two groups in terms of cognitive confidence, cognitive self-consciousness, negative beliefs about uncontrollability and danger, need to control thoughts, and positive beliefs about worry (all P >0.05). After the intervention, the above scores were increased, and the increases of the observation group were significantly greater than those of the control group (all P < 0. 05). Before the intervention, there were no significant differences in quality of life scores between the two groups in terms of life field, psychological field and spiritual belief (all P >0. 05). After the intervention, the above scores were increased, and the increases of the observation group were greater than those of the control group (ail P <0. 05). Conclusion Mindfulness meditation training combined with group yoga intervention can effectively improve the depressive and manic state of patients with manic depression, and improve their cognitive level and quality of life. [ABSTRACT FROM AUTHOR]

Research has documented that both unipolar and bipolar depression are positively correlated with involvement in delinquency and crime. The present study sought to broaden the understanding of these relationships by looking for links between offending and family histories of depressive symptoms in relationship to offspring delinquency. More than 6,000 college students and their mothers provided self-reported information regarding feelings of depression. Students provided self-reports of involvement in various categories of offending and drug use from ages 10 through 18. Numerous significant positive correlations were found between general feelings of depression and of manic depression and involvement in delinquency. The depression-delinquency relationships were strongest when considering offspring themselves, although maternal depression symptoms were also associated with various forms of offspring delinquency and drug use. To help assess the causal chains that might be involved, multiple regression and mediation analysis revealed that parental depression enhanced the probability of offspring feeling depressed and may have thereby contributed to offspring being delinquent, particularly in the case of manic depression. This study reconfirmed the well-established relationship between depression and involvement in delinquency and drug use, and suggests that it extends back to parental forms of depression, especially by the mother. [ABSTRACT FROM AUTHOR]

Starting from the hypothesis that psychosis makes up a structure with a precise status for the unconscious, the author explores how, from a Lacanian point of view, the treatment of psychosis is organized. Special attention is paid to the specificity of the psychotic symptom and the way transference characteristically takes shape. It is indicated that the occurrence of psychotic symptoms bears witness to a subjective crisis, in which no signifiers provide support when, at the level of the unconscious, the subject is dealing with fundamental self-directed epistemic questions ('who am I?') and questions concerning the intentionality of the other ('what do you want?'). Characteristically, such questions are organized around intimate topics like dealing with parenthood and authority; life in the light of death; sexuality in relation to love and procreation; and sexual identity. Psychotic crises are triggered upon confrontations with such issues in daily life, while no support by means of a master signifier or Name-of-the-Father can be found. Crucial to the Lacanian approach to treatment is that the psychoanalyst aims at restoring a place for the subject in relation to the Other, which is threatened in episodes of acute psychosis. Clinical material from Lacanian work with a female patient suffering from manic-depressive psychosis is discussed. [ABSTRACT FROM AUTHOR]

The aim of this article is to provide the reader, or anyone interested in creativity, a glimpse into the findings of existing psychological and psychiatric literature on manic depression, its occurrence in creative individuals, ways in which it manifests and affects their functioning and creative output (positively and negatively), and the lessons one can draw from these individuals attempts to creatively associate and even reconcile opposite positions. The literature from educational philosophy, psychology and psychiatry is used as a lens to examine mythological, biographical and autobiographical accounts of the lives of creative individuals, particularly frames or episodes of their mind. The construct of 'happiness' is deconstructed with didactical implications for education. [ABSTRACT FROM AUTHOR]

Mood is the changing expression of emotion and can be described as a spectrum. The outermost ends of this spectrum highlight two states, the lowest low, melancholia, and the highest high, mania. These mood extremes have been documented repeatedly in human history, being first systematically described by Hippocrates. Nineteenth century contemporaries Falret and Baillarger described two forms of an extreme mood disorder, with the validity and accuracy of both debated. Regardless, the concept of a cycling mood disease was accepted before the end of the 19th century. Kraepelin then described "manic depressive insanity" and presented his description of a full spectrum of mood dysfunction which could be exhibited through single episodes of mania or depression or a complement of many episodes of each. It was this concept which was incorporated into the first DSM and carried out until DSM-III, in which the description of episodic mood dysfunction was used to build a diagnosis of bipolar disorder. Criticism of this approach is explored through discussion of the bipolar spectrum concept and some recent examinations of the clinical validity of these DSM diagnoses are presented. The concept of bipolar disorder in children is also explored. [ABSTRACT FROM AUTHOR]

Bipolar disorder (BPD) is a lifelong mental health condition characterized by symptoms of mania, depression, and often anxiety. BPD can have detrimental consequences for individuals during pregnancy and the postpartum period, as well as for their offspring. This is often due to underdiagnosis and/or misdiagnosis as unipolar depression. There is a high incidence of first episodes of BPD in pregnant and postpartum persons. Perinatal care providers need to routinely screen for BPD and assess for relapse among those with a previous diagnosis during the pregnancy and postpartum periods. Medication management is complex and must be considered in the context of an individual's risk factors and perceptions about treatment as well as the limited evidence regarding fetal safety, using a shared decision-making model. Collaboration, consultation, and/or referral to mental health care providers are essential for managing acute and chronic BPD symptoms., (Copyright © 2022 AWHONN. Published by Elsevier Inc. All rights reserved.)

Mood is the changing expression of emotion and can be described as a spectrum. The outermost ends of this spectrum highlight two states, the lowest low, melancholia, and the highest high, mania. These mood extremes have been documented repeatedly in human history, being first systematically described by Hippocrates. Nineteenth century contemporaries Falret and Baillarger described two forms of an extreme mood disorder, with the validity and accuracy of both debated. Regardless, the concept of a cycling mood disease was accepted before the end of the 19th century. Kraepelin then described “manic depressive insanity” and presented his description of a full spectrum of mood dysfunction which could be exhibited through single episodes of mania or depression or a complement of many episodes of each. It was this concept which was incorporated into the first DSM and carried out until DSM-III, in which the description of episodic mood dysfunction was used to build a diagnosis of bipolar disorder. Criticism of this approach is explored through discussion of the bipolar spectrum concept and some recent examinations of the clinical validity of these DSM diagnoses are presented. The concept of bipolar disorder in children is also explored.

Bipolar disorders are characterized by the spontaneous, recurrent alternation of episodes of mania and depression. To investigate the type of mechanism capable of accounting for the cyclical nature of the manic depressive illness, we recently proposed a minimal model for bipolar disorders based on the assumption that the propensities to mania and depression are governed by the activities of 2 putative neural circuits that inhibit each other. When mutual inhibition is sufficiently strong, the model predicts bistability: the bipolar system is then in a stable state corresponding either to unipolar depression or mania, and can display abrupt switches between these states. To account for the cyclical nature of bipolar disorders 2 simple, additional regulations allow the model to pass from bistability to oscillations. Self-sustained oscillations provide a mechanism for the spontaneous, recurrent switching between mania and depression. The model can generate oscillations with a variety of waveforms, including periodic oscillations with comparable or unequal durations of the manic and depressive episodes, or small-amplitude oscillations around one of the 2 states preceding large-amplitude periodic changes in the propensities to mania or depression, with phases during which these propensities reach intermediate levels, a situation that could correspond to mixed bipolar states. Oscillations become irregular when fluctuations of parameter values are taken into account. The model provides a theoretical framework that covers the bipolar spectrum, i. e., cycling between the 2 poles of the disease, or evolution to a stable steady state corresponding to various degrees of unipolar depression or mania or to a "normal" state in which the propensities to mania or depression remain low, without alternation between the 2 poles of the disease. The computational approach may help the exploration of plausible mechanisms for bipolar disorders and possible dynamic bases for clinical observations on the effect of antidepressants, which can trigger the transition to mania or increase the frequency of bipolar cycling. [ABSTRACT FROM AUTHOR]

Abstract: A recent study found genome-wide significant association between common variation in the gene neurocan (NCAN, rs1064395) and bipolar disorder (BD). In view of accumulating evidence that BD and schizophrenia partly share genetic risk factors, we tested this single-nucleotide polymorphism for association with schizophrenia in three independent patient–control samples of European ancestry, totaling 5061 patients and 9655 controls. The rs1064395 A-allele, which confers risk for BD, was significantly over-represented in schizophrenia patients compared to controls (p=2.28×10−3; odds ratio=1.11). Follow-up in non-overlapping samples from the Schizophrenia Psychiatric GWAS Consortium (5537 patients, 8043 controls) provided further support for our finding (p=0.0239, odds ratio=1.07). Our data suggest that genetic variation in NCAN is a common risk factor for BD and schizophrenia. [Copyright &y& Elsevier]

Prochaska JJ, Reyes RS, Schroeder SA, Daniels AS, Doederlein A, Bergeson B. An online survey of tobacco use, intentions to quit, and cessation strategies among people living with bipolar disorder. Bipolar Disord 2011: 13: 466-473. © 2011 The Authors. Journal compilation © 2011 John Wiley & Sons A/S. Objectives: Tobacco use is prevalent among people living with bipolar disorder. We examined tobacco use, attempts to quit, and tobacco-related attitudes and intentions among 685 individuals with bipolar disorder who smoked ≥ 100 cigarettes in their lifetime. Methods: Data were collected online through the website of the Depression and Bipolar Support Alliance, a mood disorder peer-support network. Results: The sample was 67% female, 67% aged 26 to 50, and 89% Caucasian; 87% were current smokers; 92% of current smokers smoked daily, averaging 19 cigarettes/day (SD = 11). The sample began smoking at a mean age of 17 years (SD = 6) and smoked a median of 7 years prior to bipolar disorder diagnosis. Among current smokers, 74% expressed a desire to quit; intent to quit smoking was unrelated to current mental health symptoms [χ2(3) = 5.50, p = 0.139]. Only 33% were advised to quit smoking by a mental health provider, 48% reported smoking to treat their mental illness, and 96% believed being mentally healthy was important for quitting. Ex-smokers (13% of sample) had not smoked for a median of 2.7 years; 48% quit 'cold turkey.' Most ex-smokers (64%) were in poor or fair mental health when they quit smoking. At the time of the survey, however, more ex-smokers described their mental health as in recovery than current smokers [57% versus 40%; χ2(3) = 11.12, p = 0.011]. Conclusions: Most smokers living with bipolar disorder are interested in quitting. The Internet may be a useful cessation tool for recruiting and potentially treating smokers with bipolar disorder who face special challenges when trying to quit and rarely receive cessation treatment from their mental health providers. [ABSTRACT FROM AUTHOR]

Abstract: Bipolar disorders are characterized by recurrent, alternating episodes of mania and depression. To examine the dynamical bases of this cyclical illness we consider a minimal model for bipolar disorders based on the observation that the two poles of the disease are mutually exclusive. We assume that the propensities to mania and depression, which are correlated with the activity of two putative neural circuits that promote, respectively, the manic or the depressive state, inhibit each other. When mutual inhibition is sufficiently strong, the model predicts bistability: the bipolar system is then either in a depressive or in a manic state and can display abrupt switches between these stable states. We consider two simple mechanisms which, when added to mutual inhibition, allow the model to pass from bistability to oscillations. Self-sustained oscillations provide a mechanism for the spontaneous, recurrent switching between mania and depression. The model can generate oscillations with a variety of waveforms, including simple periodic oscillations with comparable or unequal durations of the manic and depressive episodes, or small-amplitude oscillations around one of the two states preceding large-amplitude periodic changes in the propensities to mania or depression. The model provides a theoretical framework that covers the bipolar spectrum, i.e., cycling between the two poles of the disease, or evolution to either mania or depression or to an intermediate state without alternating between the two poles of the disease. The model accounts for the clinical observation that antidepressants can trigger the transition to mania or increase the frequency of bipolar cycling. [Copyright &y& Elsevier]

Bipolar disorder is a common disease with a high impact in terms of personal suffering and socioeconomic burden. The disentanglement of the molecular deregulations that cause this disorder is pivotal to the understanding of its etiology. This will hopefully cast the engineering of new and more favorable treatments. New insights in the molecular aspects of bipolar disorder may be brought by the understanding of the pharmacodynamics of lithium, the first-line treatment for this disease. The mechanisms by which lithium exerts its activity in the central nervous system are not fully clarified: it is hypothesized that lithium may drive acute molecular events whose activation over time triggers long-lasting modifications in critical neuronal nets. These events are associated with long-lasting changes in the expression profile of genes in neurons that are embedded in these crucial nets. The molecular events that are acutely and chronically triggered by lithium will be reviewed here and matched with the evidence that arises from the pharmacogenetics investigations. Moreover, the pharmacogenetics reports that are not strictly associated with the mechanisms that are thought to be acutely and chronically elicited by lithium will be included in the final part of the paper. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The distribution of Kraepelin's ubiquitous dichotomy varies with standard of living and pubertal age: when one rises, the other declines. The universal similar clinical picture - mortality risk, manic depressive psychosis, episodic dysfunction of brainstem control systems (sleep-wake cycle, food, mood control mechanism) - is caused by abridged pubertal pruning of excitatory synapses, which is treated with anti-epileptics, as opposed to convulsant neuroleptics in dementia praecox, where the clinical variation reflects varying degrees of excessive pruning and deficit in excitability. Localization of cortical breakdown of circuitry, silent spots and persistent dysfunction due to insufficient fill-in mechanisms, determine the clinical picture. This ranges from dementia praecox in late puberty and poor living standards, to cognitive dysfunction (mainly with higher standards of living) with earlier puberty. This variation is the most likely explanation why the acceptance of dementia praecox as a disease entity was complicated. Kraepelin's dichotomy, episodic dysfunction against a clinical deterioration, is at the extremes of brain maturation; the fundamental property of nervous tissue, excitability, is affected. To reduce the risk of psychotic episodes, omega-3 might also be given, as it normalizes excitation at all levels. The neo-Kraepelinian atheoretical quantitative scoring systems have eliminated disease entities and neglected endogeneity in psychiatry. We are back to a pre-Kraepelinian state, without his systematic observations. What is psychiatry without Kraepelin's dichotomy? Mood stability is a fundamental personality trait with a normal distribution; what is considered within or outside normal variation is arbitrary. Given the mood-stabilizing effect of anti-epileptics and omega-3, these will increasingly dominate psychiatric treatment. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: Bipolar mood disorder carries a serious suicide risk. Panic disorder, which also confers an independent risk of suicide and psychiatric comorbidity, in general has been found to amplify suicidality in mood-disordered patients. This article assesses the available literature on how panic and suicide relate to each other in bipolar mood-disordered patients. Methods: We conducted a search on Medline and PsycINFO using the keywords “anxiety”, “attempted suicide”, “completed suicide”, “mortality”, “self-harm” in combination with “bipolar”, “manic depression” and “panic”. Twenty-four articles were included in the evaluation. Results: 14 papers support increased risk, 9 papers do not support increased risk, and 3 papers are inconclusive. Conclusions: The presence of comorbid panic disorder in individuals with bipolar disorder may confer an increased risk of suicide risk. Some papers'' reviewed have conflicting conclusions but the majority of papers support an increased risk. This is consistent with a recent (2008) literature review supporting increased risk of suicide in bipolar patients with comorbid anxiety disorders. Future research should study specific bipolar subgroups, focus on anxiety and panic symptoms rather than diagnosis, and look at the role of specific pharmacological treatment in patients with comorbid mood and anxiety disorders. [Copyright &y& Elsevier]

The article discusses in detail the management of bipolar disorder in the acute and maintenance settings. Bipolar disorder is considered a chronic, cyclical disorder that encompasses bipolar type I (BP-1) and bipolar type II (BP-II), cyclothymic disorder, and bipolar not otherwise specified. If left untreated, bipolar disorder also carries significant mortality. Patients with bipolar disorder also need to be examined for the presence of concomitant substance abuse when considering therapeutic options.

Copyright of Medizinische Genetik is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To determine the degree of association of five single nucleotide polymorphisms at the 5′-untranslated region (5′-UTR) of the human dopamine transporter gene (hSLC6A3; hDAT1) in bipolar affective disorder. Methods: In a case–control design study, the polymorphisms were genotyped for allelic and genotypic distribution between 105 index cases (50 males) with bipolar affective disorder according to DSM IV and 199 unaffected control subjects (120 males). Results: At the 5′-UTR locus of hSLC6A3, no significant allelic or genotypic differences were observed between index cases and controls. However, distinct 5-locus genotypes accumulated in subjects with bipolar affective disorder compared to control subjects (p = 0.029, odds ratio 1.84, 95% confidence interval 1.12–3.02). Conclusions: In conclusion, our data do not provide evidence for a major role of the 5′-UTR of the dopamine transporter gene in bipolar affective disorder. A minor contribution of distinct genotypes may be possible and warrants replication in extended samples. [ABSTRACT FROM AUTHOR]

Background: Sodium and potassium-activated adenosine triphosphatase (Na+, K+-ATPase) and endogenous digitalis-like compounds (DLC) in the brain have been implicated in the pathogenesis of mood disorders. This hypothesis was examined by the determination of Na+, K+-ATPase/DLC system in parietal cortex of patients with different mood disorders and two animal models of depression. Methods: Na+, K+-ATPase concentrations in human brain synaptosomal fractions, from patients with mood disorders, schizophrenia, and normal individuals, were determined by 3H-ouabain binding assay. Alpha isoforms were quantified by Western blotting. Brain DLC were measured using sensitive enzyme linked immunosorbant assay (ELISA). The effects of ouabain and ouabain-antibodies on behavior were determined in two animal models of depression. Results: 3H-ouabain binding in bipolar patients was significantly lower than in major depressed and schizophrenic patients. Na+, K+-ATPase α isoforms in synaptosomal fractions were not different among the groups. DLC levels in the parietal cortex of bipolar patients were significantly higher than in normal individuals and depressed patients. Injection of lipopolysaccharide (intraperitoneally) to rats elicited depression-like symptoms, which were significantly attenuated by pre-injection of ouabain-antibodies. Injection of ouabain and ouabain-antibodies (intracerebroventricular) reduced depression-like symptoms in the forced swimming test in rats. Conclusions: The results support the possibility that Na+, K+-ATPase and endogenous DLC participate in the pathogenesis of depressive disorders. [Copyright &y& Elsevier]

Linkage analyses of bipolar families have confirmed that there is a susceptibility locus near the telomere on chromosome 21q. To fine map this locus we carried out tests of allelic association using 30 genetic markers near the telomere at 21q22.3 in 600 bipolar research subjects and 450 ancestrally matched supernormal control subjects. We found significant allelic association with the microsatellite markers D21S171 (P=0.016) and two closely linked single-nucleotide polymorphisms, rs1556314 (P=0.008) and rs1785467 (P=0.025). A test of association with a three locus haplotype across the susceptibility region was significant with a permutation test of P=0.011. A two SNP haplotype was also significantly associated with bipolar disorder (P=0.01). Only two brain expressed genes, TRPM2 and C21ORF29 (TSPEAR), are present in the associated region. TRPM2 encodes a calcium channel receptor and TSPEAR encodes a peptide with repeats associated with epilepsy in the mouse. DNA from subjects who had inherited the associated marker alleles was sequenced. A base pair change (rs1556314) in exon 11 of TRPM2, which caused a change from an aspartic acid to a glutamic acid at peptide position 543 was found. This SNP showed the strongest association with bipolar disorder (P=0.008). Deletion of exon 11 of TRPM2 is known to cause dysregulation of cellular calcium homeostasis in response to oxidative stress. A second nonconservative change from arginine to cysteine at position 755 in TRPM2 (ss48297761) was also detected. A third nonconservative change from histidine to glutamic acid was found in exon 8 of TSPEAR. These changes need further investigation to establish any aetiological role in bipolar disorder.Molecular Psychiatry (2006) 11, 134–142. doi:10.1038/sj.mp.4001759; published online 4 October 2005 [ABSTRACT FROM AUTHOR]

The human serotonin transporter gene (5-HTT) is a candidate for the pathogenesis of mood disorders, including bipolar disorder (BPD). The 5-HTT gene has a 44-bp insertion/deletion polymorphism within the promoter region (5-HTTLPR) with 2 allelic forms, the long ( l) and the short ( s) variants, which affect transcriptional rates of the 5-HTT gene. Association between the low-activity s variant and BPD has been suggested but remains controversial, as replication has not been consistent. In the present study, we examined the frequency of this polymorphism in a group of 266 Brazilian BPD patients and 306 control subjects. Genotyping for the 5-HTTLPR was performed using PCR. The allele frequencies were found to differ between BPD patients and controls ( p=0.03), with a higher frequency of the l allele in the patients compared with the controls (60.5% vs 54.4%). The distribution of genotypes also differed significantly between cases and controls ( x 2=10.4, 2 df, p=0.005), with higher frequency of heterozygous l/s genotype in the BPD patient group (52.6% vs 44%). Because prior evidence from gene expression studies indicated that l/s and s/s genotypes are not distinguishable biochemically, we compared the distribution of the l/l genotype and the combined group l/s plus s/ s between case and controls, but there was no significant difference ( x 2=0.22). Likewise, a logistic regression model considering a dominant role for the s variant was not significant (OR=0.92, 95% CI 0.64–1.32). Our results suggest that the low-activity s variant does not influence susceptibility to BPD in our population. [ABSTRACT FROM AUTHOR]

Abstract: Defining the underlying causes of psychiatric disorders has provided an ongoing and intractable problem. The analysis of the genetic basis of manic depression, in particular, has been impeded by the absence of a suitable model system and by the lack of candidate causative genes. One recent approach to overcome these problems has involved identifying those genes which control the sensitivity to anti-manic drugs in a model organism. Characterisation of the role of these genes and their encoded proteins in this model has allowed the analysis of their mammalian homologues to elucidate the therapeutic role of these drugs and the possible aetiology of manic depression. This approach has been used successfully with the cellular slime mould, Dictyostelium discoideum. This article introduces the use of model systems for pharmacogenetics research. It describes the identification of prolyl oligopeptidase in D. discoideum as a modulator of inositol phosphate signalling, and the subsequent identification of a common mechanism of action of three anti-manic drugs in mammalian neurons. The use of pharmacogenetics in model systems will provide a powerful tool for the ongoing analysis of both the treatment and cause of psychiatric disorders. [Copyright &y& Elsevier]

Our previous results pointed to a putative gene for susceptibility to bipolar affective disorder located on the chromosomal region 12q23-q24 that segregated in the Saguenay-Lac-St-Jean population of Quebec. We report here results from a second genome-wide scan based on the analysis of 380 polymorphic microsatellite markers. For the purpose of this analysis, an additional 18 families were recruited from the Saguenay-Lac-St-Jean region and pooled to our previous sample to improve its statistical power, giving a total of 394 sampled individuals. This work confirms the presence of a susceptibility locus for affective disorder on chromosome 12q24 with parametric LOD score value of 3.35 at D12S378 when pedigrees were broken into nuclear families and analysed under a recessive segregation model. This result was supported by neighbouring markers and by a LOD score value of 5.05 at D12S378 under model-free analysis. Other regions of lower interest were indicated on chromosomes 2, 5, 7, 9, 10, 17 and 20.Molecular Psychiatry (2005) 10, 545-552. doi:10.1038/sj.mp.4001601 Published online 19 October 2004 [ABSTRACT FROM AUTHOR]

Thomas Szasz has made major contributions to many areas of psychiatric thought. He has correctly decried ‘diagnosis creep’ in American psychiatry and emphasized the potential for political abuse of psychiatric labels. He has correctly asserted that only individuals with a true brain disease should qualify as having a ‘mental illness’ but unfortunately ignores overwhelming evidence that schizophrenia has been proven to be a brain disease. His unchanging views on schizophrenia, despite contemporary scientific evidence, appear increasingly anachronistic and allow critics to dismiss his other contributions, many of which remain valuable. [ABSTRACT FROM AUTHOR]

Once considered virtually nonexistent, bipolar disorder in children has recently received a great deal of attention from mental health professionals and the general public. This paper provides a current review of literature pertaining to the psychosocial treatment of children with early-onset bipolar spectrum disorder (EOBPSD). Commencing with evidence of the emerging interest in this topic, we then focus on terminology, the rationale for studying EOBPSD in children, current research and clinical progress, possible explanations for the recent increase in recognition, and essential issues that form the foundation of effective psychosocial treatment. Next we explore areas of research with direct implications for psychosocial treatment. These include biological and psychosocial risk factors associated with bipolar disorder; and the psychosocial treatment of adult-onset bipolar disorder, childhood-onset unipolar disorder, and anger management in children. Following this, we discuss treatments being developed and tested for children with EOBPSD. Finally, we conclude with recommendations for future studies needed to move the field forward. [ABSTRACT FROM AUTHOR]

Background: Several sleep laboratory studies suggest sleep abnormalities in bipolar disorder. However, this is the first study to compare remitted bipolar subjects with controls on actigraphic and subjective sleep parameters in a naturalistic setting over 5 nights. Methods: Nineteen subjects with Bipolar I Disorder and 19 age- and gender-matched healthy controls were included. Objective sleep parameters were estimated using wrist actigraphs. Subject-rated sleep diaries and mood ratings were also completed. Sleep data were averaged for each subject across nights, and raw score standard deviations were calculated as a measure of within-subject variability. Results: Multivariate analyses of variance found significant group differences for both actigraphic (F(4,33)=3.80, P=0.012) and subjective measures (F(4,31)=3.18, P=0.027). Univariate analyses identified reliable differences in sleep onset latency (subjective), sleep duration (subjective), and variability of sleep duration and night wake time (actigraphic). Binary backward stepwise logistic regression demonstrated that a combination of three sleep measures correctly predicted disorder status in 84% of cases. Limitations: Failure to match on sociodemographic and employment status is a limitation that may provide an alternative explanation for some findings. Furthermore, in the bipolar group 18 of 19 subjects were in receipt of psychotropic medication, compared to none of the healthy control group. Also, no information was recorded about family history of mental disorders in the control group. Conclusions: The study suggests that the sleep of remitted bipolar outpatients measured in naturalistic settings is characteristically different from controls: bipolar subjects sleep longer, report longer onset latencies, and display greater variability across nights. [Copyright &y& Elsevier]